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English Despite growing awareness of and enthusiasm for evidence-based practice (EBP) among front-line social care staff employed by member agencies of the Centre for Evidence-based Social Services, using evidence in practice is a demanding task. This article highlights some of the challenges to evidence-based practice experienced by those involved in its implementation, which can be characterised as cultural, infrastructural and practical. Despite these hurdles, creative, practical steps have been taken by social care staff to promote EBP within their workplaces, and these are briefly summarised.

Background: Patient and public involvement (PPI) can help with steering and shaping research prioritisation and execution. However, some groups of people may not be encouraged to take part and their voices may be seldom listened to in the production of research. This is important to consider because they may have poorer healthcare experiences. We wanted to try out using art as a vehicle for including individuals not necessarily invited to be part of research priority setting. Methods: We contacted existing groups and organisations to reach people who are not routinely supported to be part of PPI. We targeted individuals: a) with dementia, b) with mental health conditions, and c) from Black, Asian and Minority Ethnic backgrounds. We ran a workshop with each group at which individuals shared their experiences of healthcare. A young amateur artist also attended, who produced a piece of artwork afterwards that reflected the research priorities raised. We held a Twitter chat to discuss the final pieces of art that were created, and the processes involved in their generation.Results: From each workshop, we produced a list of research priorities. These included: a) improving coordination of care for people with dementia, b) supporting discussion of women’s health issues in South Asian communities, c) information needs, anxiety/guilt around accessing care and costs associated with this for people with a mixture of physical and mental health conditions. These priorities were reflected in three pieces of art, which can be viewed online. Feedback from those at workshops suggested that the artwork has helped them to feel their voice has been heard and triggered their interest in how research is developed. Those involved in the Twitter chat commented that art was one means through which researchers could connect with a range of groups in a PPI context when preparing and then producing a study. Conclusions: We found the medium of art to be an effective way of including a range of people in research prioritisation setting. This approach could be useful for future public involvement and engagement, building on what we have learnt from the project described in this paper.

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Background: The patient centred-medical home (PCMH) was conceived to address problems that primary care practices around the world are facing, particularly in managing the increasing numbers of patients with multiple chronic diseases. The problems include fragmentation, lack of access and poor coordination. The PCMH is a complex intervention combining high-quality primary care with evidence-based disease management. Becoming a PCMH takes time and resources, and there is a lack of empirically informed guidance for practices. Previous reviews of PCMH implementation have identified barriers and enablers but failed to analyse the complex relationships between factors involved in implementation. Using a theoretical framework can help with this, giving a better understanding of how and why interventions work or do not work. This review will aim to refine an existing theoretical framework for implementing organisational change – the Consolidated Framework for Implementation Research (CFIR) – to apply to the implementation of the PCMH in primary care.Methods: We will use the ‘best fit’ framework approach to synthesise evidence for implementing the PCMH in primary care. We will analyse evidence from empirical studies against CFIR constructs. Where studies have identified barriers and enablers to implementing the PCMH not represented in the CFIR constructs, we will use thematic analysis to develop additional constructs to refine the CFIR. Searches will be undertaken in MEDLINE (Ovid), Embase (Ovid), Web of Science Core Collection (including Science Citation Index and Social Science Citation Index) and CINAHL. Gaps arising from the database search will be addressed through snowballing, citation tracking and review of reference lists of systematic reviews of the PCMH. We will accept qualitative, quantitative and mixed methods primary research studies published in peer-reviewed publications. A stakeholder group will provide input to the review.Discussion: The review will result in a refined theoretical framework that can be used by primary care practices to guide implementation of the PCMH. Narrative accompanying the refined framework will explain how the constructs (existing and added) work together to successfully implement the PCMH in primary care. The unpopulated CFIR constructs will be used to identify where further primary research may be needed.Systematic review registration: PROSPERO CRD42021235960